Crucial Option for Women
In California, women can ask a pharmacist for the so-called morning-after pill without a doctor’s prescription. On Tuesday, the Food and Drug Administration will hold hearings on the question of whether women in California and elsewhere should get the drug more easily. Twenty-five years of experience in this country and abroad has proved emergency contraception to be safe and effective at preventing pregnancy for millions of women for whom contraception failed, or who were raped. It should be more freely available.
The drug’s safety and efficacy are largely settled, and not the FDA’s focus Tuesday. Instead, the major question is whether women should be able to buy the morning-after pill anytime they need it -- including on weekends and holidays, when it’s most difficult to see a doctor for a prescription. Timing is critical with this medication.
Emergency contraception consists of a single dose of birth control pills that, if taken within 72 hours of intercourse, can cut the chance of pregnancy by nearly 90%. The drug works by delaying ovulation, preventing fertilization or inhibiting the egg from implanting in the uterus. Implantation, which generally occurs 12 days after fertilization, is the accepted medical threshold of pregnancy, though some abortion opponents wish to define it as fertilization of the egg. They have also argued that the pill causes abortions, but medical studies have found that if an egg implants, emergency contraception won’t affect it. The drug’s major side effect is nausea.
In about 30 other nations and in five states, including California, selected pharmacists dispense the morning-after pill from behind their counters when women ask for it. Several surveys found that many women who wanted the pill would not ask for it.
Would the more widespread sales that are proposed tempt teenagers to abuse the drug or take it in secret, to avoid telling their parents they’d had sex? These are risks, but by that logic teens shouldn’t be able to buy condoms. Would over-the-counter sales make women more careless about regular birth control, as some argue? A 1998 study in the New England Journal of Medicine concluded that women did not use the drug as a substitute for normal contraception.
Over-the-counter sales could prevent up to half of the estimated 1.7 million unintended pregnancies each year and thousands of abortions. That’s why the major medical societies of obstetricians, pediatricians and family physicians endorse the sales proposal. The FDA should too.
